Surgical Treatment for Endometriosis

If endometriosis symptoms are not alleviated with medication, or if your doctor thinks you may benefit from surgery, NYU Langone doctors may recommend a procedure to remove endometrial implants and scar tissue. NYU Langone surgeons are experts in fertility-sparing removal of endometriosis, which preserves the uterus and other reproductive organs while relieving the pain caused by the condition.

At NYU Langone, our doctors perform two types of laparoscopic surgery to treat endometriosis. Depending on your preference and future pregnancy plans, a hysterectomy, or removal of the reproductive organs, may be recommended. All of these surgeries require general anesthesia.

Laparoscopy

If endometriosis is suspected, laparoscopic surgery may be planned to diagnose and treat women with endometriosis. The surgeon removes any visible endometrial implants and scar tissue at the same time as the diagnostic procedure. This minimally invasive surgery takes place in the hospital but requires only small incisions and a relatively short recovery time.

In laparoscopy, a surgeon makes a series of small incisions in the abdomen and inserts a thin scope with a light and camera at the tip. The surgeon uses the scope, which magnifies the doctor’s view, to look for endometrial implants and scar tissue throughout the abdomen, such as in the space behind the uterus called the cul-de-sac and on organs, such as the uterus, bladder, ovaries, fallopian tubes, bowel, and rectum. The implants and scar tissue are removed with the surgical instruments, and the tissue is sent to a laboratory, where a pathologist analyzes it to confirm the diagnosis.

Laparoscopy may also be used when medications for endometriosis fail to relieve symptoms.

You may go home the same day of the procedure, and you can expect to return to your normal activities in 10 to 14 days.

Robotic-Assisted Laparoscopy

Like laparoscopy, surgeons use robotic laparoscopy to find and remove endometrial implants and scar tissue. Robotic surgery gives doctors a high-resolution, three-dimensional view of small areas around the pelvic organs and allows for precise movements to remove or destroy endometrial implants and scar tissue. As with traditional laparoscopy, you can expect to return to your normal activities in 10 to 14 days.

Hysterectomy

Hysterectomy is the surgical removal of the uterus and may play a role in the treatment of endometriosis. Most of the time, it is not necessary to remove the ovaries, which is a procedure called an oophorectomy. After a hysterectomy, your period stops, but only removal of the ovaries causes the body to enter menopause. This can lead to the common effects of menopause, including hot flashes and bone density loss, no matter your age. Your doctor can help you to decide whether this surgery is appropriate for you and, if so, to develop a plan to help you manage the symptoms of menopause.

Hysterectomy can be performed in several ways. Doctors can perform a laparoscopic hysterectomy, a robotic laparoscopic hysterectomy, or a traditional “open” surgery. Open surgery is rarely necessary. For most hysterectomies, you can go home the same day, and recovery typically takes two weeks. For open surgery, you may need to stay in the hospital at least one night, and recovery can take four to six weeks.